The collection of receivable accounts and distribution of funds to pay invoices are tasks inherent to any business venture. Over time, electronic payment and automated account withdrawal methods have become available to help ease the transaction costs and efforts involved in collecting and making payments. In some industries, however, despite the availability of electronic funds transfers, the collection and payment process is particularly time and effort intensive. This is especially the case in those industries in which collections and payments are being handled by a third party agency where insurance claims are involved, and where guarantors may be self-insured, insured through a third party, or both. The health care industry is one such example, where a single visit to a health care provider initiates a cascade of financial transactions that are designed to settle and pay at least a portion of the doctor's bill.
For an example illustrating one common but complex collection and payment methodology, consider the prior art health care payment process 100 depicted in FIG. 1. A employee (EE) of an employer (ER) who is an insured party 110 is a patient (or provides insurance benefits to the patient by familial relationship to) who seeks care from a doctor or other health care provider 120, and as an initial step before treatment, provides 115 health insurance information to the health care provider 120. The provider 120 then renders 107 a service to the patient 110, resulting in a bill or invoice being sent 122 to a third party Health Care Plan Administrator (HCPA) 130, or other entity that is designated by the patient's health insurance as the point of contact for initiating a claim or request for payment. The HCPA 130 then determines the correct address for a guarantor, typically the patient's employer 140, which may commonly be self-insured, and forwards 131 the claims and/or fund requests to the employer 140. The employer 140, if it has not already done so, deposits 141 funds into a bank or other financial institution 150, and sends 142, payment information such as account electronic fund transfer information to the HCPA 130, enabling the HCPA 130 to obtain funds to satisfy the claim. Using the information furnished by the employer 140, the HCPA then contacts the employer's bank 150, via an electronic funds transfer process 132, in order to obtain funds to remunerate the health care provider 120. In response, the bank 150 transfers 143 the funds to an account specified by the HCPA 130, and in turn, the HCPA 130 can provide a payment 123 to health care provider 120 to settle the bill or invoice.
While the process 100 provides for payment of health care-related bills, it does so with a significant amount of overhead. For example, each time a claim needs to be paid, the HCPA 130 needs to determine who to contact to obtain funding, to submit a request for instructions, to wait for the employer 140 to return the instructions on where to obtain the funding, then needs to contact the funding source such as the bank financial institution 150 to obtain funds. Further, the employer 140 may be contacted numerous times by third party processors requesting instructions for payment for medical invoices, adding increased overhead expense.
As a single visit to a health care provider 120 results in a large number of financial transactions, a more efficient method would be desirable to help reduce the inescapable impact of passing overhead expenses to increasingly financially burdened and time constrained employees 110. What is needed, then, is a method to improve efficiency of prior art collections processing. What is also needed is a method to automate collection of funds without continued involvement of a guarantor. What is further needed is an approach to collect and store information about guarantors and their associated banks, financial institutions, or funding sources.